Clover

The Medicare plan that gives you more.

Clover is more than a Medicare plan. We're here to look out for you—to give you the tools
you need to live healthier... so you can focus on living happier.

Get your FREE Information Kit now.

You're just a click away from finding out more about the many benefits of a Clover Medicare
plan. It's EASY, and there's no obligation.

Just complete and submit the form below.
Or give us a call at 1-888-466-0531 (TTY 711).

First name*

Last name*

Address*

City*

State*

ZIP code*

Email

Phone*

By entering my phone number and/or email address, I agree that Clover may call or email me,
provide me with information about the plan, and answer any questions I may have.

Please have a licensed salesperson contact me by text message. I agree to receiving text messages from Clover Health at the telephone number above, and I understand that these texts may be placed using an automated telephone dialing system. I understand that my consent to receive text messages is not a condition of receiving any products or services and that I can opt out at any time by responding “STOP” to a text message.

Last Updated: 9/01/2018

Clover Health is a Preferred Provider Organization (PPO) and a Health Maintenance Organization (HMO) with a Medicare contract. Enrollment in Clover Health depends on contract renewal. You must continue to pay your Medicare Part B premium. For plans that provide drug coverage, the formulary may change during the year. Out-of-network/non-contracted providers are under no obligation to treat Clover members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Medicare beneficiaries may also enroll in Clover Health through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.

Disclaimers

This information is not a complete description of benefits. Call 1-888-657-1207 (TTY 711) for more information. Limitations, copayments, and restrictions may apply. Plan performance Medicare Star Ratings are assessed each year and may change from one year to the next. Benefits, premiums, and/or copayments/coinsurance may change on January 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.